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Journal Article

Citation

Armitage AJ, Cohen J, Heys M, Hardelid P, Ward A, Eisen S. Arch. Dis. Child. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, BMJ Publishing Group)

DOI

10.1136/archdischild-2021-322319

PMID

34656979

Abstract

OBJECTIVE: (1) To describe a novel integrated pathway for unaccompanied asylum-seeking children (UASC).(2) To evaluate a population engaged with this service.

DESIGN: Description of the integrated pathway (objective 1) and retrospective evaluation, using data from community paediatrics, infectious diseases (IDs) screening and a sexual health (SH) service (objective 2). SETTING: Unlinked data were collected from three services across three National Health Service (NHS) trusts in London. PATIENTS: All Camden UASC engaged with the service from 01 January 2016 to 30 March 2019. INTERVENTIONS: A multidisciplinary approach prioritising the health needs of UASC including a childre and adolescent mental health service (CAMHS) clinican and a health improvement practitioner. There are low thresholds for onward referral and universal asymptomatic screening of UASC for ID. MAIN OUTCOME MEASURES: Data on demographics, unmet health needs and known outcomes.

RESULTS: Data were available for 101 UASC, 16% female, median age 16 years (range 14-17). Physical assault/abuse was reported in 67% and 13% disclosed sexual assault/abuse, including 38% of female UASC. Mental health symptoms were documented in 77%. IDs warranting treatment were identified in 41% including latent tuberculosis (25%) and schistosomiasis (13%). Interpreters were required for 97% and initial non-attendance rates at follow-up were 40% (ID) and 49% (SH).

CONCLUSIONS: These data demonstrate high rates of historical physical and sexual assault/abuse, unmet physical, mental and emotional health needs among UASC and significant barriers to engaging with services. An integrated pathway has been successfully implemented and shown to deliver appropriate, joined-up care for UASC, consistent with current recommendations, with the potential to improve outcomes.


Language: en

Keywords

child abuse; health services research; adolescent health

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